Reviewing the evidence on arm and shoulder rehabilitation following critical illness

In 2023, over 215,000 patients were admitted to ICUs across England, Wales, and Northern Ireland. Around a third of these people developed ‘ICU-acquired weakness’, a common complication where muscles, especially in the limbs, significantly weaken. This can lead to a loss of independence. While more than 80% of ICU survivors are discharged, many face long-term physical, psychological, and quality-of-life challenges. These can persist for up to five years after discharge. These challenges lead to more use of healthcare and prolonged unemployment. ICU recovery outcome measures generally focus on mobility and respiratory care. Arm and shoulder function hasn’t been properly addressed. Studies show that 59% of ICU survivors experience musculoskeletal pain, particularly in the shoulders. They report reduced arm strength and quality of life compared to healthy people, six months after discharge. There are no guidelines or outcome measures specifically for assessing or rehabilitating arm and shoulder function in ICU patients. Project aims We will explore current research and clinical practices around arm and shoulder function in ICU survivors. This will help us understand where there are gaps in the evidence and where there is potential for improving support in this area. What we hope to achieve ICU survivors’ health outcomes and interactions with the healthcare system (including readmissions) could be impacted by arm and shoulder weakness. We hope this research will give this issue more attention, helping improve care and quality of life for ICU survivors.